NORTH SHORE MEDICAL PLLC (NPI# 1083966170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083966170 |
| Entity Type | Organization |
| Organization Name | NORTH SHORE MEDICAL PLLC |
| Practice Address |
21008 Northern Blvd Suit 1a Bayside NY 11361-3211 |
| Mailing Address |
65-11 Booth Street Suite 1c Rego Park NY 11374 |
| Practice Telephone | 7182810833 |
| Practice Fax Number | 7182810566 |
| Mailing Telephone | 7188061434 |
| Mailing Fax Number | 7188061435 |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2014-01-08 |
| Authorized Official Name | MARVIN BASE (DIRECTOR) |
| Authorized Official Telephone | 7188061434 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 187770 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
21008 NORTHERN BLVD SUIT 1A |
| City | BAYSIDE |
| State | NY |
| Zip Code | 11361-3211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568447548 | Jill M Diamond | Audiologist | 21008 Northern Blvd, Suite 5, Bayside, NY 11361-3211 | 2005-12-13 |
| 1396384921 | Christina Ricciardi | Nurse Practitioner | 21008 Northern Blvd, Bayside, NY 11361-3211 | 2019-12-30 |
| 1578921904 | Kiarra Domenique Caneda Aldea | Physical Therapist | 21008 Northern Blvd, Ste 1, Bayside, NY 11361-3211 | 2016-01-30 |
| 1013314004 | Atom Physical Therapy PC | Specialist | 21008 Northern Blvd, Suite #1, Bayside, NY 11361-3211 | 2014-11-19 |
| 1558629899 | Pcl Hearing Services of New York, LLC | Specialist | 21008 Northern Blvd, Suite 5, Bayside, NY 11361-3211 | 2012-04-24 |
| 1518145366 | Jesse Ko, Md, Pllc | Pediatrics | 21008 Northern Blvd, Suite 1a, Bayside, NY 11361-3211 | 2008-02-04 |
| 1356475990 | Lawrence J. Deutsch Phd, PC | Audiologist | 21008 Northern Blvd, Suite 5, Bayside, NY 11361-3211 | 2007-03-15 |
| 1427120526 | Fryer Dermatology, Pllc | Dermatology | 21008 Northern Blvd, Bayside, NY 11361-3211 | 2006-11-14 |
| 1467534610 | Kuai-hua Chiang | Physical Therapist | 21008 Northern Blvd, Ste #1, Bayside, NY 11361-3211 | 2006-10-19 |
| 1497856751 | Eric J Fryer | Dermatology | 21008 Northern Blvd, Bayside, NY 11361-3211 | 2006-09-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467078055 | Nicole E. Sarracco | Speech-Language Pathologist | 215 - 46 39th Avenue, Flushing, NY 11361 | 2020-06-19 |
| 1689294381 | Terri Robin Will | Registered Nurse | 3416 2019th Street, Queens, NY 11361 | 2020-04-22 |
| 1295364875 | Melanie Besthoff | Speech-Language Pathologist | 215-46 39th Avenue, Flushing, NY 11361 | 2020-04-05 |
| 1790339844 | Alana Valle | Occupational Therapist | 20947 34th Rd, Bayside, NY 11361 | 2019-07-26 |
| 1881175826 | Eva Mui | Pharmacist | 212 Northern Blvd, Bayside, NY 11361 | 2018-08-28 |
| 1063908531 | Hongik Acupuncture N.y. P.C. | Acupuncturist | 21441 42nd Ave Ste 4c, Bayside, NY 11361 | 2018-07-07 |
| 1093233694 | Karen Trentacosta | Registered Nurse | 40-04a Bell Boulevard, Bayside, NY 11361 | 2017-09-03 |
| 1801310131 | Hee Gi An | Dentist | 42-05 204th St, Flr 2, Bayside, NY 11361 | 2017-07-28 |
| 1780113050 | Miaoying Zhu | Social Worker | 217-63 Corbett Rd, Bayside, NY 11361 | 2017-06-08 |
| 1679016265 | Daniela Ragusa | Speech-Language Pathologist | 221-21 Corbett Road, Bayside, NY 11361 | 2016-11-30 |
| Find all providers in zip 11361 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265838056 | Soe K Aung | Internal Medicine | 4229 Clearview Expy, Bayside, NY 11361-2644 | 2014-11-06 |
| 1861823411 | Jenny Liaw, M.d. Pllc | Internal Medicine | 42-23 212 Street, Suite 1a, Bayside, NY 11361 | 2013-12-09 |
| 1437580461 | Island Medical Care, Pllc | Internal Medicine | 202-28 45th Ave, Bayside, NY 11361-2540 | 2013-12-02 |
| 1023451010 | Darya Blednova | Internal Medicine | 21008 Northern Blvd Ste 1a, Bayside, NY 11361-3211 | 2013-04-10 |
| 1093067498 | Yueting Shang | Internal Medicine | 4316 215th St Apt 1, Bayside, NY 11361-2976 | 2012-10-09 |
| 1649527177 | Harbin Medical Care Pllc | Internal Medicine | 43-16 215 Street, Bayside, NY 11356 | 2012-08-15 |
| 1093002339 | Elina Yushuvayev | Internal Medicine | 22215 Northern Blvd Lbby A, Bayside, NY 11361-3603 | 2011-07-07 |
| 1982990495 | Md Ashfiqur Rahman | Internal Medicine | 210-08 Northern Boulevard, Suite 1a, Bayside, NY 11361-3211 | 2011-06-22 |
| 1164712329 | Matthew Nicholas Mavroson | Internal Medicine | 4201 Bell Blvd, Bayside, NY 11361-2863 | 2011-04-08 |
| 1912236811 | Ion Oltean Physician PC | Internal Medicine | 139 66 35th Ave, Bayside, NY 11354 | 2009-12-24 |
| Find all providers in BAYSIDE | ||||
Please comment or provide details below to improve the information on NORTH SHORE MEDICAL PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.